Composite bone cements based on halloysite nanotube with enhanced drug elution.

Antibiotic-loaded PMMA (polymethylmethacrylate) bone cement (ALBC) is widely used to prevent and treat periprosthetic joint infections (PJIs), yet its clinical efficacy is limited by issues like burst release and short release duration. To address these challenges, this study developed a composite bone cement (HV-PMMA) loaded with vancomycin-functionalized halloysite nanotubes (HNTs-Van). The results showed that HV-PMMA optimized antibiotic elution: it avoided initial burst release, and the drug elution amount of HV-PMMA was superior to that of traditional ALBC with vancomycin formulation. The addition of HNTs-Van slightly reduces the compressive strength of the bone cement. Importantly, HV-PMMA maintained good biocompatibility, with a hemolysis rate below 5% and no acute systemic toxicity. This nano-scale physical drug-loading strategy effectively solves the limitations of traditional ALBC, providing an efficient and safe approach for designing antibacterial bone cements to prevent and treat PJIs.